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President Obama on Tuesday gave Americans a 90-day update on his signature health care initiative - returning to the familiar topic that allowed the president to highlight his biggest political victory instead of again defending his response to the BP oil spill.

Joined at the White House by Ohio mother Amy Wilhite and several other Americans who have already benefited from the Affordable Care Act, the president announced new regulations and used the event to criticize Republicans in midterm races who are vowing to repeal the legislation.

The new regulations will strengthen the law’s so-called “patients’ bill of rights,” including the end of insurance companies denying coverage to children with pre-existing medical conditions and caps on lifetime coverage limits.

Though such limits will be lifted Sept. 23 by most companies, the one that insured Mrs. Wilhite’s daughter, Taylor, diagnosed in 2007 with a fast growing form of leukemia, has already extended its $1 million cap by an additional $500,000.

“A huge burden has been lifted,” said Ms. Wilhite as Mr. Obama put a hand on her shoulder.

“This is a true patients’ bill of rights,” said Mr. Obama, who vowed that by September some of the worst abuses by insurance companies will be “banned forever.”

Afterward, Sen. Orrin G. Hatch, Utah Republican, said that Mr. Obama making more promises is a bad idea, considering the problems keeping the ones made earlier.

“It’s a mystery why the administration would make even more they cannot keep,” said Mr. Hatch, who estimates the initiative will cost $2.5 trillion over 10 years. “This shouldnt be called a health care bill of rights, but a bill of goods that the American people arent buying. … Ninety days after the president signed it into law, one thing hasnt changed: The American people are as opposed now as they were then. Politically motivated threats wont lower skyrocketing health care costs.”

Mr. Obama made the announcement amid continuing voter concern about the expanded role of government and that a major component of the initiative - health coverage for roughly 32 million uninsured Americans - doesn’t begin until 2014.

In addition, adults with pre-existing conditions will not be guaranteed coverage until that year. But Mr. Obama said the administration will have a high-risk pool by July 1 for uninsured Americans with health problems.

The president also said some seniors are already getting $250 checks to help cover prescription medication, 4 million will receive such assistance by the end of the year and the so-called “doughnut hole” in insurance coverage will be “closed completely” by 2020.

Another major concern among Americans is increasing insurance rates.

The president and top administration officials met privately before the speech with state insurance commissioners and executives from major insurance companies. However, the president did not take questions regarding the outcome of the discussions.